<div class="page-content-wrap">

    <div class="row">
        <div class="col-md-12">

            <form class="form-horizontal">
                <ul></ul>
                <div class="page-title">
                    <h2>
                        <a href="#">
                            <i class="fa fa-arrow-circle-o-left"></i></a>

                        <span id="title">title</span>
                    </h2>
                </div>

                <p>desciption</p>

                <div class="panel panel-default"></div>
            </form>
        </div>
    </div>
</div>
<script>

</script>